Corporate Update. August NASDAQ: GALT Galectin Therapeutics Inc.

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1 Corporate Update August 2015 NASDAQ: GALT Galectin Therapeutics Inc.

2 Forward-Looking Statements This presentation contains, in addition to historical information, forward-looking statements within the meaning of the Private Securities Litigation Reform Act of These statements relate to future events or future financial performance, and use words such as may, estimate, could, expect and others. They are based on our current expectations and are subject to factors and uncertainties which could cause actual results to differ materially from those described in the statements. These statements include those regarding potential therapeutic benefits of our drugs, expectations, plans and timelines related to our clinical trials, potential partnering opportunities and estimated spending through mid Factors that could cause our actual performance to differ materially from those discussed in the forward-looking statements include, among others, our trials may not lead to positive outcomes or regulatory approval. We may experience delays in our trials, which could include enrollment delays. Future phases or future clinical studies may not begin or produce positive results in a timely fashion, if at all, and could prove time consuming and costly. Plans regarding development, approval and marketing of any of our drugs are subject to change at any time based on the changing needs of our company as determined by management and regulatory agencies. Strategies and spending projections may change. We may be unsuccessful in developing partnerships with other companies or obtaining capital that would allow us to further develop and/or fund any studies or trials. We are currently the subject of litigation, which may impact our human and capital resources. To date, we have incurred operating losses since our inception, and our future success may be impacted by our ability to manage costs and finance our continuing operations. For a discussion of additional factors impacting our business, see our Annual Report on Form 10-K for the year ended December 31, 2014, and our subsequent filings with the SEC. You should not place undue reliance on forward-looking statements. Although subsequent events may cause our views to change, we disclaim any obligation to update forward-looking statements. 2

3 Program Summary NASH (non alcoholic steatohepatitis) is an unmet medical need with a very large potential global market Late-stage NASH, with advanced fibrosis/cirrhosis is desirable from regulatory and commercial perspectives Preclinical studies with GR-MD-02 indicated positive effects on multiple aspects of NASH, including fibrosis reversal Completed Phase 1 studies demonstrated drug was safe and well tolerated and provided proof-of-concept on anti-fibrotic activity Currently engaged in two Phase 2 NASH clinical trials in cirrhosis and advanced fibrosis without fibrosis Investigator-initiated studies in cancer immunotherapy and psoriasis enhance the GR-MD-02 opportunity Strong executive leadership team with extensive experience 2015 Galectin Therapeutics NASDAQ: GALT 3

4 Experienced Executive Leadership Team James Czirr, Executive Chairman Peter G. Traber, M.D. President, CEO, CMO Harold H. Shlevin, Ph.D. COO & Corporate Secretary Jack W. Callicutt CFO 4

5 Developing Products For Major Unmet Medical Needs Clinical Focus Stage of Development Drug Indication Discovery Preclinical Phase 1 Phase 2 Phase 3 Fibrosis (monotherapy) GR-MD-02 NASH cirrhosis June 2015 NASH advanced fibrosis Lung, Kidney, Cardiovascular fibrosis Cancer Immunotherapy (combination therapy) GR-MD-02 + Yervoy GR-MD-02 + Keytruda Melanoma Melanoma Plaque Psoriasis (exploratory) 2H 2015 Aug 2015 GR-MD-02 Moderate-severe Aug 2015 Galectin-3 Inhibitors Discovery program to identify subcutaneous and oral forms of carbohydrates and oral small molecules 5

6 Drugs That Target Galectin-3 Protein May Impact These Unmet Medical Needs Galectin-3 Protein Function Role in Disease Binds to multiple glycoproteins (sugar-containing proteins) Integral to multiple cellular pathways, particularly in the innate immune system High expression in immune cells (macrophages) Gal-3 is increased in inflammation and fibrogenesis Elimination of gal-3 in mice prevents fibrosis in liver, lung, kidney and heart The majority of cancers express high levels of gal-3, which promotes tumor and inhibits immune response Lead Drug Candidate GR-MD-02 A complex carbohydrate that disrupts gal-3 function, particularly affecting immune/repair function in macrophages Extensive analytical analysis using state-of-the-art methods to support human use Existing patent coverage through 2031 with 2 composition and 5 method US patents issued Efficacy in preclinical fibrosis models in liver, lung, kidney and heart with encouraging human results in liver fibrosis 6

7 Fatty Liver Disease (NASH) Is An Epidemic With No Approved Therapies And A Very Large Market Opportunity Estimated prevalence of NASH in U.S. adults may be as high as 28 million and growing 1, 2 U.S. Prevalence in Asymptomatic Adults (% of population studied) 2 Obesity Diabetes Fatty Liver NASH 45% 17% 46% 12% Estimated US prevalence of advanced fibrosis 2,3 : Estimated U.S. prevalence of cirrhosis 3 : ~ 6 million ~ 1-2 million 1 Based on July 2013 U.S. census data for people >20 years old 2 Prospective evaluation of NAFLD and NASH prevalence (Williams, et al. Gastro. 2011;140: ) Note: population recruited for this study were between ages 18 and 70 3 Kleiner, et al. Hepatology 2005;41:

8 Scarring (Fibrosis) Of The Liver In Late Stage NASH Leads To Patient Morbidity and Mortality: Galectin Is Addressing Late Stage Disease Early Disease (low stage fibrosis) Late Disease (advanced fibrosis) Fibrosis Progression Stage 1 Stage 2 Stage 3 Stage 4 Liver biopsy (Blue = fibrosis) Cirrhosis No increased mortality* Asymptomatic Increased mortality* *All cause mortality as compared to reference group with prospective follow up of up to 33 years (Ekstedt, et al. Hepatology 2015;61: ) 8

9 Galectin Therapeutics Is Targeting Late Stage NASH Phase 2 programs (several other programs are in Phase 1 or preclinical) Early Disease (low stage fibrosis) Late Disease (advanced fibrosis) Stage 1 Stage 2 Stage 3 Stage 4 (Cirrhosis) Obeticholic Acid (Intercept) GFT505 (GenFit) Liraglutide (Novo Nordisk) Aramchol (Galmed) Cysteamine (Raptor) Cenicriviroc (Tobira) Emricasan (Conatus) Simtuzumab (Gilead) GR-MD-02 (Galectin) Focus of development programs and regulatory endpoints must be on fibrosis Early stage development programs may be challenging given no change in mortality for early disease over a long period of time Late-stage NASH, with advanced fibrosis/cirrhosis is desirable from regulatory and commercial perspectives 2015 Galectin Therapeutics NASDAQ:GALT 9

10 Fundamental Science on Target is Strong: Galectin-3 Is Critically Important In Development Of Fibrosis Galectin-3 null mice (no galectin-3) are resistant to fibrosis due to toxin-induced liver toxicity Red stain is collagen, the principal component of fibrotic tissue Mice treated with liver toxin to induce fibrosis Normal mouse No gal-3 mouse Normal mice develop fibrosis whereas those without gal-3 do not Henderson, et al 2006 Galectin-3 null mice are also resistant to fibrosis in: Fatty liver disease Kidney fibrotic disease Lung fibrotic disease 2015 Galectin Therapeutics NASDAQ:GALT 10

11 Preclinical Data Shows That GR-MD-02 Can Reverse NASH, Fibrosis, and Cirrhosis Mouse model of NASH Reduces inflammation, fat, and cell death Prevents as well as reverses fibrosis Targets macrophages and reduces galectin-3 Peer-reviewed publication: Traber PG and Zomer E. Therapy of Experimental NASH and Fibrosis with Galectin Inhibitors. PLOS ONE 2013;8:e83481 Rat model of liver fibrosis/cirrhosis Reduces inflammation and cell death Reverses fibrosis and cirrhosis Reduces portal hypertension associated with cirrhosis Targets macrophages and reduces galectin-3 Peer-reviewed publication Traber PG, Chou H, Zomer E, Hong F, Klyosov A Fiel M-I, Friedman, SL. Therapy of Regression of fibrosis and reversal of cirrhosis in rats by galectin inhibitors in thioacetamide-induced liver disease. PLOS ONE 2013;8:e Galectin Therapeutics NASDAQ: GALT 11

12 GR-MD-02 Reversed Cirrhosis In Rat Model Toxin induced cirrhosis in rats; toxin continued during GR-MD-02 treatment Vehicle-Treated (control) GR-MD-02-Treated (4 weekly doses) Reduces portal pressure which correlates with primary endpoint in cirrhosis trial 12

13 Galectin-3 is at the nexus of multiple pathophysiological processes in NASH and fibrogenesis Cause of Liver Injury Mediators Glucose Intolerance Metabolic Syndrome Fat Accumulation Impaired Lipid Metabolism Hyperglycemia Adipo-Cytokines Free Fatty Acids Potential sites of anti-galectin activity Hepatocyte Advanced lipoxidation endproducts (ALE) Advanced glycation endproducts (AGE) Macrophage Macrophage effects: pro-inflammatory cell type recruitment of monocytes inflammatory cytokines Inflammation Multiple inflammatory cytokines Hepatocyte/Macrophage effects: scavenger receptor activity ALE and AGE uptake cellular toxicity Fibrosis Quiescent Activated Stellate Cell effects: activation TGF-b1 receptor activity collagen production Stellate Cell Resolution ECM Dissolution Stellate Cells Macrophages MMPs Extracellular Matrix Extracellular matrix/collagen dissolution: restorative macrophage activity matrix metalloproteases 2015 Galectin Therapeutics NASDAQ:GALT 13

14 Phase 1 Trial In NASH Patients With Advanced Fibrosis Provides Strong Foundation For Phase 2 Program Performed under IND for NASH patients with advanced fibrosis with Fast Track designation from FDA Multiple dose escalation, double-blind, placebo-controlled trial in NASH patients with advanced fibrosis GR-MD-02 was safe and well tolerated Highest dose in targeted therapeutic window for drug administration Highest dose tested may have an effect on liver fibrosis Reduced FibroTest, a composite test of 5 serum markers Serum alpha-2 macroglobulin, a component of the FibroTest accounted for the reduction Reduced liver stiffness assessed by FibroScan Proof of pharmacodynamic effect supports phase 2 controlled clinical trials 14

15 Statistically Significant Reduction In Alpha-2 Macroglobulin (A2M) Serum Levels Seen At The 8 mg/kg Dose A2M is involved in fibrogenesis and correlates to degree of liver fibrosis ns 4 Legend and Notes: ns 3 4 th dose + 14 da Cohort 1 2 mg/kg 4 th dose + 3 da Cohort 2 4 mg/kg p < p < p < nd dose 4 th dose 4 th dose + 3 da + 14 da Cohort 3 8 mg/kg 1. Mean ± standard deviation 2. Placebo values were combined for all three cohorts because there were no differences (n=19 separate data points) 3. Not significant versus placebo, two-sided t-test (n=6) 4. Not significant versus placebo, two-sided t-test (n=7) 5. Significant for three groups versus placebo, ANOVA with Dunnett s test for multiple comparisons (n=7) 15

16 Evidence Of Reduced FibroScan Scores In Cohort 3 Patients Treated With GR-MD-02 3 of 5 patients treated with GR-MD-02 had reduction in liver stiffness to below 80% of baseline values (red squares)* Placebo GR-MD-02 (8 mg/kg) 120% 80% *FS added during cohort 2, but only available at most centers for cohort 3. In cohort 3 there were technically adequate scans at baseline, Day 38 and Day 63 in 5 patients administered GR-MD-02 and 3 patients administered placebo. Five patients in cohort 3 were not available for FibroScan analysis (3 placebo and 2 active) because of unavailability of the instrument at the site (1 placebo and 1 active), unavailability of the appropriate instrument probe (1 active), a technically inadequate baseline scan (1 placebo), and the Day 63 scan not being performed (1 placebo). 16

17 A Second Phase 1 Trial In Normal Volunteers Extends Safety Profile and Expands Eligible Patients 18 normal volunteers evaluated for interaction of GR-MD-02 with midazolam, a model CYP3A4 drug metabolism substrate Single and multiple doses of GR-MD-02 had no effect on pharmacokinetics of midazolam GR-MD-02 was safe and well tolerated In the two phase 1 trials, 38 subjects received 132 doses of GR- MD-02 and showed excellent safety profile Lack of an effect on CYP3A4 drug metabolism, responsible for metabolism of many marketed drugs Expansion of number of patients eligible to be included in Phase 2 clinical trials Expands future potential commercial population 17

18 Phase 2 Clinical Trials Focus On Two Indications In NASH Patients With Advanced Fibrosis Indication Objective Expectation From Successful Study NASH-CX NASH with Cirrhosis (Stage 4) 1 Year of Therapy Reduction of portal pressure and liver fibrosis Has potential to be a pivotal trial NASH-FX NASH with Advanced Fibrosis, but not Cirrhosis (Stage 3) 4 Months of Therapy Reduction of liver fibrosis as assessed using three noninvasive tests Basis for future P2b or P3 trials With positive results, either of these studies could be basis for FDA Breakthrough application 18

19 The NASH-CX Trial (GT-026) Design Fibrosis Portal Pressure Complications Morbidity and Mortality Primary Endpoint: Reduction of hepatic venous pressure gradient (HVPG) as a measure of portal pressure compared to placebo at 1 year of treatment Secondary Endpoints: At least one stage change in histopathological fibrosis stage Liver collagen on liver biopsy (digital morphometric analysis) Liver stiffness as determined by FibroScan Score Metabolic capacity of the liver as determined by 13 C methacetin breath test Progression of cirrhosis as determined by complications https://clinicaltrials.gov/ct2/show/nct ?term=gr-md-02&rank=3 19

20 The NASH-FX Trial (GT-028) Design Reduction of liver fibrosis as assessed using three non-invasive tests Primary Endpoint: Difference between placebo and GR-MD-02 in the baseline adjusted mean change in liver fibrosis as measured by corrected T1 (ct1) mapping as determined from LiverMultiScan (LMS), a multi-parametric MRI protocol. Secondary Endpoints: To determine the baseline-adjusted change in magnetic resonance elastography (as measured in kpa) To determine the baseline-adjusted change in Fibroscan Score (as measured in kpa) https://clinicaltrials.gov/ct2/show/nct ?term=gr-md-02&rank=3 20

21 Non-Invasive Assessments Of Liver Fibrosis In NASH-FX Trial Normal LiverMultiScan* MR-Elastography Transient Elastography (FibroScan ) Transducter Probe Ribs Vibrator Cirrhosis Whole liver assessment of fibrosis using multi-parametric magnetic resonance imaging *Perspectum Diagnostics Banerjee, et al. J. Hepatol. 2014;60:69-77 Whole liver assessment of stiffness using magnetic resonance imaging with mechanical pulse Regional assessment of liver for tissue stiffness (FDA approved) Echosense 21

22 Summary of NASH Advanced Fibrosis Program Galectin-3 a well-validated target in pre-clinical studies GR-MD-02 binds gal-3 and is targeted to macrophages In pre-clinical models GR-MD-02 has multiple effects Reduces inflammation, fat and ballooning hepatocytes in NASH Reduces and reverses liver fibrosis and cirrhosis Reduces portal pressure, an endpoint of NASH-CX trial In NASH patients with advanced fibrosis, GR-MD-02 has been safe and well tolerated, therapeutic doses have been defined, and there was evidence of effect on fibrogenic process in patients GR-MD-02 is well suited to target NASH with advanced fibrosis and cirrhosis, an area with less competition than early NASH Phase 2 clinical trial program address different patient populations NASH-CX trial in cirrhosis with top line results end of 2017 NASH-FX trial in stage 3 fibrosis with top line results 2H Galectin Therapeutics NASDAQ: GALT 22

23 Cancer Therapy Strategy: Focus on Combination Immunotherapy Critical Collaboration Established Earle A. Chiles Research Institute (EACRI) at the Franz Cancer Research Center, Providence-Portland Medical Center, Portland Oregon Demonstrated clinical trial expertise in melanoma and tumor immunology basic science research Conducted preclinical work and are funding clinical trials with GR-MD-02 Focus on Immunotherapy Advanced Melanoma as Initial Indication Galectin-3 has an important role in reducing the ability of immune system to fight cancer EACRI have done animal studies showing that GR-MD-02 combined with other immunotherapy drugs enhances anti-tumor activity and improves survival In U.S. 73,000 new diagnoses and 9,900 deaths* Even with newly approved drugs, a substantial unmet medical need remains *American Cancer Society 23

24 Potential Sites Of Action For Galectin Inhibition In Tumor Immunology Immunotherapies Checkpoint Inhibitor Blockage: anti-ctla4 anti-pd1 + Clonal Expansion CD8+ T-Cells Galectin-3 Tumor Cells Galectin-3 T-Cells CD8+ T-Cells Cytokines (kill tumor cells) Potential for galectin inhibitors to enhance anti-tumor immune response Potential for galectin inhibitors to enhance antitumor activity of T-cells 24

25 Checkpoint Inhibitors Plus GR-MD-02 Boosts Anti- Tumor Immunity, Reduces Tumor Size And Increases Survival In Mouse Cancer Models These data are on TC-1 prostate cancer cells (also effective in breast cancer, melanoma, and sarcoma) *p<0.05 actla-4 = anti-ctla-4 mab [ipilimumab in humans (Yervoy, BMS)] apd-1 = anti-pd-1 mab [pembrolizumab in humans (KEYTRUDA ) Merck] Unpublished data 2013: Stefanie N. Linch, Melissa J. Kasiewicz, Peter G. Traber, and William L. Redmond, Galectin Therapeutics and Earle A. Chiles Research Institute (EACRI), Portland Oregon 25

26 Patients Alive Hypothesis: GR-MD-02 May Be Used In Combination With Other Immunotherapies To Enhance Patient Survival Immune checkpoint blockade Plus GR-MD-02 Hypothetical effect of combination PD-1-blockade (KEYTRUDA ) CTLA-blockade (Yervoy ) Years Natural History Note: these are illustrative curves not representative of actual data; redrawn from figure of the American Association for Cancer Research, 2013 Supportive preclinical data in Appendix 26

27 Providence Portland Medical Center Conducting Two Investigator-Initiated Melanoma Phase 1b Clinical Trials Phase 1b Clinical Trial In Patients With Advanced Melanoma Using GR-MD-02 In Combination With Yervoy Patients enrolled: Advanced melanoma with indication for Yervoy treatment Dose escalation with GR-MD-02 with standard Yervoy Measure tumor and immune system response Dose group 1 complete (1 mg/kg) no dose-limiting toxicity Study details on clinicaltrials.gov https://clinicaltrials.gov/ct2/show/nct ?term=gr-md-02&rank=1 Phase 1b Clinical Trial In Patients With Advanced Melanoma Using GR-MD-02 In Combination With KEYTRUDA Patients enrolled: Progression after Yervoy and/or BRAF targeted therapy Progression after KEYTRUDA monotherapy Remainder of design mirrors first study EACRI plans to initiate in 2H

28 Exploratory Indication Moderate-to-severe plaque psoriasis Patient in Phase 1 trial had apparent remission of severe psoriasis while receiving 4 mg/kg of GR-MD-02 Galectin-3 plays important role in skin and there is increase in skin vessels of patients with psoriasis 1,2 Open-label, single site, 10 patient study to evaluate the effect of 3 months of GR-MD-02 on the number of patients who have 75% improvement in Psoriasis Activity Severity Index (PASI-75) Details on clinicaltrials.gov https://clinicaltrials.gov/ct2/show/nct ?term=gr-md-02&rank=5 1 Larsen L, et al. J. Derm Sci. 2011;64: Lacina L, et al. Folia Biologica. 2006;52: Galectin Therapeutics NASDAQ: GALT 28

29 Expected Development Program Milestones Advanced Liver Fibrosis/Cirrhosis Study Indication Endpoints Start Data Reporting GT-026 NASH-CX GT-028 NASH-FX Advanced Melanoma Study Indication Endpoints Start Data Reporting Phase 1b: Yervoy NASH with cirrhosis NASH with advanced fibrosis Advanced melanoma Portal pressure (HVPG); liver biopsy Multi-parametric MRI Comparisons include MRE and FibroScan Safety ir-recist Immune markers Underway End 2017 August H 2016 Underway Dose Group 1: complete Dose Group 2: enrolled Dose Group 3: initiated Phase 1b: KEYTRUDA Psoriasis Advanced melanoma Safety ir-recist Immune markers 2h 2015 Study Indication Endpoints Start Data Reporting Phase 2a: GT-030 Moderate to severe plaque psoriasis Psoriasis Activity Severity Index (PASI) TBD Sept Q

30 Program Summary NASH (non alcoholic steatohepatitis) is an unmet medical need with a very large potential global market Late-stage NASH, with advanced fibrosis/cirrhosis is desirable from regulatory and commercial perspectives Preclinical studies with GR-MD-02 indicated positive effects on multiple aspects of NASH, including fibrosis reversal Completed Phase 1 studies demonstrated drug was safe and well tolerated and provided proof-of-concept on anti-fibrotic activity Currently engaged in two Phase 2 NASH clinical trials in cirrhosis and advanced fibrosis without fibrosis Investigator-initiated studies in cancer immunotherapy and psoriasis enhance the GR-MD-02 opportunity Strong executive leadership team with extensive experience 2015 Galectin Therapeutics NASDAQ: GALT 30

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